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The EMS system and disaster planning: some observations.

Disaster planning, one of the 15 essential components of the Emergency Medical Service System Act of 1973, should be the culmination of the establishment of other components. Regions have gone to varying lengths to describe disaster plans but how realistic the plans are is questionable. New York has planned for multiple casualty incidents (MCI) to care for victims of fires, explosions, structural collapses and major transportation incidents. The irrational emotional response in mass disasters conflicts with the rational disaster plans written by health planners. Drills of disaster plans are not realistic. One solution is to designate the next serious incident, such as a fire or traffic accident, a major MCI. The ability to handle an MCI is probably the best measure of an EMS system's effectiveness.

Disaster Planning

An emergency medical system approach to disaster planning.

The increasing prevalence of terrorist attacks and natural disasters has mandated that more emphasis be placed on emergency disaster planning. The report focuses on the 1976 Courthouse bombing in Boston, which generated 20 casualties. Ambulance response by Boston's Emergency Medical Service system was made in 2.5 minutes and all victims were transported from the scene within 20 minutes. Successful management of this incident employed several important principles of disaster planning. These include the initial medical response, staging at the scene, and hospital notification. Additionally, the concept of triage as an integral part of disaster planning is explained with examples of the on-site medical stabilization and treatment of casualties. The importance of these concepts in practice and the necessity of close coordination of ambulance response and the responses of other emergency agencies, i.e., Police and Fire, were clearly demonstrated in the disaster which resulted from the Courthouse bombing.

Adult

Role of medical teams in a community disaster plan.

In London, Ont. two mock disaster exercises have indicated the need for re-evaluating the role of medical disaster teams. To coordinate and direct these teams a medical on-site coordinating team, composed of three emergency physicians with an expanded and more clearly defined role, was formed. The role of the triage teams deployed from the hospital to assess and resuscitate casualties is reviewed in detail. In addition, the communication systems, availability and deployment of medical supplies, identification of medical personnel and tagging of casualties are discussed. Because a mass casualty episode is possible in any community, disaster planning and clear outlining of the role of medical disaster teams are needed.

Disaster Planning

Updating disaster plans: a tale of three hospitals.

Three hospitals that were struck by disaster in 1977 have undertaken major revision of their disaster plans as a result of unexpected problems that occurred during the crises. Lee Hospital, Johnstown, PA, is installing a tough "floodproofing" system; Jewish Hospital and Medical Center, Brooklyn, NY, and Bellevue Hospital Center, New York City, are revamping their emergency electrical systems.

Disaster Planning

Disaster planning.

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Disaster Planning

[Development and trial of a civic disaster plan (author's transl)].

Because of the changing complexities of the world the potential for disaster changes from day to day. It is, therefore, the responsibility of every community to plan for possible disasters and to alter their plans as the disaster potential for their community changes. "Exercise London" showed that a workable community plan can be prepared, and illustrated the errors that can occur in handling a large number of casualties. These errors are now being corrected and, when it seems feasible, another exercise will be carried out.

Canada